• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.253-260
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• 2015

Purpose: The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods: Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results: The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion: A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance.

• The Journal of the Korea Contents Association
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• v.10 no.12
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• pp.190-204
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• 2010

This study firstly examined the socioeconomic and health factors associated with infiltration of private health insurance. Secondly, we compared health behavior, outpatient and inpatient use of private health insured with uninsured. The method of this study is that secondary analysis of the 2008 Korea National Health and Nutrition Survey was conducted for 7178 respondents aged 19 over. We use the logistic regression and t-test for data analysis. The first dependent variable was dichotomy which is divided to private health insured or uninsured and the second dependent variable was the presence and frequency of outpatient and inpatient use. The descriptive variables was gender, age, marital status, income, education, occupation, type of national health insurance, residential area, self confidence of health, prevalence rate of common disease, activity limitation, drinking and smoking status. The result of the major findings are as follows. First, 59 under aged person, married person, people in the higher brackets of income, national employee insured were more likely to infiltrate private health insurance. The poor self confidence of health, activity limitation, person with hypertension or allergic rhinitis and smoker were negatively related in infiltrating private health insurance. Second, private health insured did more preventive behavior such as self-paid health examination, cancer screening, regular exercise than uninsured. Third, private health insured was positively related with the presence of outpatient use and frequency of inpatient use

• The Journal of Pediatrics of Korean Medicine
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• v.1 no.1
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• pp.79-89
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• 1986

During 34 months from October 1982 to July 1985, a clinical study was made on 217 cases of out-patients with pediatric bronchoarthma at Kyung-Hee University Oriental Hospital. ?The observed results were as follows; ?1. In the age of the patients ranged from six months to twelve years; they were almost under six years (73.1 %) The ratio of male to female was 3: 1. ?2. In case of the age to be attacked with bronchoarthma, the age 3 covered 43.9% (95 cases), and the ages of less than 6 years 86.3% (187 cases); and, especially, the age 2 - 3 covered the highest rate (18.4%; 40 cases) ?3. The contraction period of bronchoarthma was almost less than one year (70.1%; 152 cases); especially, less than one week covered the highest rate (22.1 %; 48 cases) ?4. In case of the contraction season; winter (December to February) had the highest rate (33.2%; 72 cases), and fall, spring and summer came after it. And 13 cases (6%) were attacked in all seasons. ?5. Of a day, the severe symptom was shown most frequently from 6 pm to midnight (31.3%; 68 cases), and next from midnight to 6 am (29.1%; 62 cases) ?6. The common symptoms of out-patients were productive cough (24.0%; 147 cases), easily-catch-cold (22.5%; 138 cases), dry cough (11.4%; 70 cases), and so on. ?7. In case of the history of the patients, upper respiratory infections covered 52.1 % (113 cases) bronchitis(29.0%; 63 cases), pneumonia(17.1%; 37 cases), and tonsilitis& pharyngitis(6.0%; ?13 cases): and allergic symptoms covered (42 cases: 19.3%) fetal fever & eczema (11.5%: 25 cases), and allergie Rhinitis (7.8%: 17 cases) ?8. The family of the patients were shown to have the history of bronchitis (21.6%; 47 cases), bronchoarthma (21.2%; 46 cases), and tuberculosis (16.6%; 36 cases) ?9. The factors of bronchoarthma were shown as upper respiratory infections (38.3%; 38 cases), cold weather (18.9%; 41 cases), and exercise (175%; 38 cases) ?10. Of the treatment periods of the patients, less than one month (69.2%; 150 cases) took the highest rate, in which less than a week was 33.2% (72 cases) and one or two weeks 15.2% (33 cases) ?11. The main prescriptions were kunpyunetang (79 cases; 17.0%), Agoayangyuegunpyuetang (73 cases; 15.7%) and Haepyoyangjintang (72 cases; 15.6%) ?12. In the results of treatment, 132 cases (60.9%) was improved; especially, subjective signs of 33 cases (15.2%) of them, was almost removed.

• Allergy, Asthma & Immunology Research
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• v.10 no.6
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• pp.591-613
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• 2018

Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

• YAKHAK HOEJI
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• v.52 no.3
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• pp.188-194
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• 2008

Fexofenadine, ($\pm$)-4-1-hydroxy-4-{4-(hydroxydiphenylmethyl)-1-piperidinyl}-butyl-a,a-dimethyl benzeneacetic acid, is a selective histamine $H_1$ receptor antagonist, and is clinically effective in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria as a first-line therapeutic agent. The purpose of the present study was to evaluate the bioequivalence of two fexofenadine hydrochloride tablets, $Allegra^{(R)}$ (Handok Pharmaceuticals Co., Ltd.) and Alecort (Samchundang Pharmaceutical Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of fexofenadine from the two fexofenadine hydrochloride formulations in vitro was tested using KP VIII Apparatus II method with various dissolution media. Twenty six healthy male subjects, 25.62$\pm$3.35 years in age and 70.05$\pm$11.71 kg in body weight, were divided into two groups and a randomized 2$\times$2 cross-over study was employed. After a single tablet containing 120 mg as fexofenadine hydrochloride was orally administered, blood samples were taken at predetermined time intervals and the concentrations of fexofenadine in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar in all tested dissolution media. The harmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Allegra^{(R)}$, were -1.37, 5.22 and 16.50% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.83$\sim$log 1.08 and log 0.81$\sim$log 1.03 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Alecort tablet was bioequivalent to $Allegra^{(R)}$ tablet.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.3
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• pp.84-94
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• 2005

Objective: In order to help clinical approach on OME patient in progress observation and decision on improvement by clinical research results using tympanometry. Methods: Data was collected from 163 ears of 96 patients who were treated in Dept. of Oriental Medical Ophthalmology & Otolaryngology & Dermatology, Kyung-Hee Medical Center from 2001-2-12 to 2005-4-29 for Otitis Media with Effusion(OME). Tympanometry was applied to all patients and the test result was used to evaluate progress and improvement. F/U cases below 3 times were excluded. Results & conclusion: 1. Age and sex distribution was as follows: Mean Age 5.5years old(Standard deviation: 2.1), age distribution 2-61years old, below 10years old 151cases(92.6%) and above 10years old 12cases(7.4%). Male and female ratio was 1.81:1. 2. There were 67people(69.8%) with bilateral affected ear. Unilateral was 29people(30.2%). Affected ear distribution according to sex came out similarly. 3. Affected period distribution was as follows: over 12weeks 71cases(43.6%), under 12weeks 92cases(56.4%). Out of under 12weeks cases, 2-4weeks was 34cases(20.9%), 0-1weeks and 5-8weeks 20cases(12.3%), 9-12weeks 18cases(11.0%). There was evident difference about affected period between male and female. 4. All patients who served previous Tx in medical clinic(118 cases) took antibiotics. Only 6cases took tube insertion. The period of Taking antibiotics was as fellows: over 6weeks 42cases(35.6%), under 5weeks 37cases(31.4%). unknown 25cases(21.2%), jntermittent 14cases(11.9%). 5. In Period of Tx distribution, 5-6weeks showed 40cases(24.5%) which was highest number. In Improved cases(85cases), 3-4weeks and 5-6weeks each 22cases(25.9%) which was highest number. 1-2weeks 3cases(3.5%), 7-8weeks 12cases(14.1%), 9-10weeks 9cases(10.6%), 11-12weeks 10cases(11.8%), over 12weeks 7cases(8.2%). 6. The cases which have gastrointestinal Sx were 71cases(43.6%), the others 92cases(56.4%). Details of gastrointestinal Sx were as follows: Sx associated with appetite 47cases(47.5%), constipation 15cases(15.2%), abdominal pain and diarrhea 14cases(14.1%), frequent vomitting Teases(7.1%), etc 4cases(4.0%). 7. The cases which have accompanying disease were 116case(71.2%), the other 47cases(28.8%). Details a accompanying disease were as follows: sinusitis 57cases(35%), rhinitis 55cases(3.7%), allergic rhinitis 20cases(12.3%), atopic dermatitis 19cases(1.7%), urticaria 4cases(2.5%), asthma 3cases(1.8%), nasal polyp and conjunctivitis 2cases(1.2%) each, laryngitis 1case(0.6%).

• Pediatric Infection and Vaccine
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• v.18 no.2
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• pp.182-192
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• 2011

Purpose : Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection. Methods : A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups. Results : Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P <0.001), asthma (65% vs 35%, P =0.011), allergic rhinitis (71% vs 40%, P =0.009), and IgE level (P =0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P =0.007). Conclusion : Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.

• Journal of Nutrition and Health
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• v.52 no.6
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• pp.559-568
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• 2019

Purpose: This study examined the prevalence of food allergies and allergenic factors in a selected sample of children living in Seoul, Korea, along with their dietary habits, environmental factors, and diseases as risk factors for food allergy. The results of this study will provide basic data for addressing food allergies. Methods: We selected 3,004 pre-school and school-age children, aged 0 ~ 12, in the 25 districts of Seoul as the study sample. Structured self-report questionnaires were administered over a two-month period in July-August 2018, and the children's parents recorded the answers on their children's behalf. The research tools in this study included the Korean version of the questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC). Results: The physician-diagnosed prevalence rate of food allergies was 14.2%, while 20.4% of the children experienced allergic symptoms at least once and 17.4% reported symptoms within the previous 12 months. The children's symptoms included skin problems (88.1%), gastrointestinal issues (19.2%), oral issues (16.7%), respiratory issues (12.7%), and systemic issues (1.3%). The causes of allergies included eggs, peaches, milk, peanuts, and shrimps. The factors influencing the experience of food allergies were the consumption of cereal (aOR, 1.52; 95% CI, 1.09 ~ 2.10; p = 0.013), potatoes (aOR, 1.88; 95% CI, 1.33 ~ 2.65; p < 0.001), and fast food (aOR, 1.73; 95% CI, 1.10 ~ 2.72; p = 0.017). Having food allergy symptoms was associated with a higher risk of experiencing asthma (aOR, 4.22 95% CI, 3.10 ~ 5.76; p < 0.001), allergic rhinitis (aOR, 2.53; 95% CI, 2.03 ~ 3.15; p < 0.001), and atopic dermatitis symptoms (aOR, 3.56; 95% CI, 2.88 ~ 4.40; p < 0.001). Conclusion: Episodes of food allergies warrant examining regular food consumption and placing dietary restrictions through early diagnosis as these episodes may imply the presence of other allergies. Our findings offer basic insights into the patterns, prevalence and symptoms of children's food allergies in Seoul, and our findings will contribute to identifying effective interventions for food allergies.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.559-573
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• 1997

Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.146-153
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• 1997

Background : Chronic cough is commomly defined as a persistent or recurrent cough exceeding 3 week's duration. The prevalence of chroinc cough is reported to range from 14% to 23 % for nonsmoking adults. The post nasal drip syndrome has been determined to be the most common cause of chronic cough, followed by asthma, chronic bronchitis, gastroesophageal reflux and bronchiectasis. Cough can be the only manifestation of asthma. Bronchial provocation tests are useful in diagnosing cough variant asthma. We investigated the clinical or laboratory findings and the incidence of airway hyperresponsiveness and evaluated the etiology in patients with chronic cough. Method : We evaluated 46 patients with chronic cough. Methacholine challenge test were done. Results : The results were as follows : 1) Thirty - five percent(16/46) of the chronic cough patients and 44% of the post nasal drip syndrom(7/16) showed the positive responses to methacholine challenge test 2) The underlying causes of chronic cough were post nasal drip syndrome in 35%, bronchitis in 21.7%, cough-variant asthma in 17.4%, and unknown condition in 25.9%. 3) Airway hyperresponsiveness in chronic cough was not related to respiratory symptom, nasal symptom, post nasal drip, smoking, derangement of ventilatory function, atopy, or sinusitis. Conclusion : Airway hyperresponsivenss in patients with chronic cough increased in frequency when compaired with normal control, allergic rhinitis. Cough-variant asthma account for 17.4% of patients with chronic cough.